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Sacubitril-Valsartan May Be Cost-Effective Option in HFrEF

More costly than enalapril but more effective over a lifetime in heart failure with reduced ejection fraction

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THURSDAY, April 7, 2016 (HealthDay News) -- For patients with heart failure with reduced ejection fraction (HFrEF), sacubitril-valsartan may be cost-effective, depending on the willingness-to-pay threshold, according to a study published online March 30 in JACC: Heart Failure.

Jordan B. King, Pharm.D., from the University of Utah College of Pharmacy in Salt Lake City, and colleagues examined the cost-effectiveness of sacubitril-valsartan compared with enalapril for treatment of HFrEF. Costs, effects, and cost-effectiveness of the therapies were estimated using a Markov model. At model entry, patients were 60 years of age, and were modeled over 40 years from the perspective of a third-party payer.

The researchers found that over a lifetime, compared with enalapril, sacubitril-valsartan was more costly ($60,361 versus $21,758) and more effective (6.49 versus 5.74 quality-adjusted life-years [QALYs]) in the base case. The cost-effectiveness of sacubitril-valsartan varied with treatment duration, from $249,411 per QALY at three years to $50,959 per QALY gained over a lifetime.

"Sacubitril-valsartan may be a cost-effective treatment option depending on the willingness-to-pay threshold," the authors write. "Future investigations should incorporate real-world evidence with sacubitril-valsartan to further inform decision making."

Several authors disclosed financial ties to Amgen.

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